阵发性偏侧头痛的临床特征分析

Study on paroxysmal hemicrania

摘要:

目的:对文献报道的具有典型阵发性偏侧头痛(paroxysmal hemicrania, PH)表现的病人进行分析,探讨成人、儿童阵发性偏侧头痛临床特征及治疗反应,以优化其诊治效率。方法:检索PubMed、Embase、Cochrane Library、中国知网、万方数据库自1988年至今已发表的具有典型PH样表现的病例,提取发病年龄、性别、头痛部位、持续时间、发作次数、伴随的自主神经症状、吲哚美辛反应剂量等相关信息。结果:共42篇文献114例病人纳入分析,其中成人PH 94例,平均发病年龄38.82±13.36岁,男:女1:1.35,吲哚美辛有效剂量为100mg·kg-1·d-1,17%存在继发因素,且发病年龄大于原发性PH(46.13±19.46 vs 37.32±11.33, P<0.05)。20例儿童平均7.36±4.00岁发病,男性占60%,吲哚美辛平均起始剂量为2.93mg/kg。结论:继发性PH发病年龄更大,建议对所有PH病人进行神经系统影像学检查和长期随访。

Abstract:

Objective: This study aimed to enhance the diagnostic efficiency of typical paroxysmal hemicrania (PH) by investigating its clinical characteristics in adult, pediatric cases. Methods: We conducted computerized retrieval to obtain a comprehensive collection of representative case studies on pulmonary hypertension (PH) published from 1988 to the present, encompassing databases such as PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Database. Extract relevant information including age of onset, gender, location of headache, duration, frequency of attacks, associated autonomic symptoms, and dosage of acetazolamide. Results: A total of 42 studies involving 114 patients were included in the analysis. Among them, there were 94 adult patients, with an average age of onset of 38.82 ± 13.36 years. The male-to-female ratio was 1:1.35. The effective dose of indomethacin was 100mg·kg-1·d-1. 17% of patients had secondary factors, and their age of onset was greater than that of primary cases (46.13±19.46 vs 37.32±11.33, P<0.05). Twenty pediatric patients had an average age of onset of 7.36 ± 4.00 years, with males accounting for 60%. The average initial dose of indomethacin was 2.93 mg/kg. Conclusion: Secondary PH have a later age of onset. It is recommended to perform neuroimaging examinations and long-term follow-up for all PH patients.